Treatment of appendicitis: Do Medicaid and non-Medicaid-enrolled patients receive the same care?

被引:4
|
作者
Fazzalari, Amanda [1 ,2 ]
Pozzi, Natalie [2 ]
Alfego, David [3 ]
Erskine, Nathaniel [1 ]
Shi, Qiming [3 ]
Tourony, Gary [4 ]
Mathew, Jomol [5 ]
Litwin, Demetrius [1 ]
Cahan, Mitchell A. [1 ]
机构
[1] Univ Massachusetts, Med Sch, Dept Surg, 55 Lake Ave N, Worcester, MA 01655 USA
[2] St Marys Hosp, Stanley J Dudrick Dept Surg, Waterbury, CT USA
[3] Univ Massachusetts, Div Data Sci & Technol, Med Sch, Worcester, MA 01655 USA
[4] Univ Massachusetts, Dept Finance, Med Ctr, Worcester, MA 01655 USA
[5] Univ Massachusetts, Dept Populat & Quantitat Hlth Sci, Med Sch, Worcester, MA 01655 USA
关键词
INSURANCE STATUS; RACIAL DISPARITIES; HEALTH-CARE; SURGERY; OUTCOMES; MANAGEMENT; ACCESS; RACE; PERFORATION; ADULTS;
D O I
10.1016/j.surg.2019.06.035
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Studies using national data sets have suggested that insurance type drives a disparity in the care of emergency surgery patients. Large databases lack the granularity that smaller, single-institution series may provide. The goal of this study is to identify factors that may account for differences in care between Medicaid and non-Medicaid enrollees with appendicitis in central Massachusetts. Methods: All adult patients with acute appendicitis in an academic medical center between 2010 and 2018 were included. Sociodemographic and clinical characteristics were compared according to Medicaid enrollment status. Analyses were performed to assess differences in the frequency of operative treatment, time to surgery, length of stay, and rates of readmission. Results: The sample included 1,257 patients, 10.7% of whom (n = 135) were enrolled in Medicaid. The proportions of patients presenting with perforated appendicitis (28.9% vs 31.2%, P = .857) and undergoing laparoscopic appendectomy (96.3% vs 90.7%, P = .081) were similar between the 2 groups, as were length of stay (20 hours 30 minutes versus 22 hours 38 minutes, P = .109) and readmission rates (17.8% vs 14.5%, P = .683). Medicaid enrollees did experience somewhat greater time to surgery (6 hours 47 minutes versus 4 hours 49 minutes, P < .001). Conclusion: Despite anticipated differences in population, the treatment of appendicitis was similar between Medicaid and non-Medicaid enrollees. Medicaid enrollees experienced greater time to surgery; however, further studies are needed to explain this disparity in care. (C) 2019 Elsevier Inc. All rights reserved.
引用
收藏
页码:793 / 799
页数:7
相关论文
共 50 条
  • [31] Medication adherence and health care costs associated with biologics in Medicaid-enrolled patients with psoriasis
    Bhosle, Monali J.
    Feldman, Steven R.
    Camacho, Fabian T.
    Whitmire, J. Timothy
    Nahata, Milap C.
    Balkrishnan, Rajesh
    JOURNAL OF DERMATOLOGICAL TREATMENT, 2006, 17 (05) : 294 - 301
  • [32] Medication adherence and health care costs associated with biologics in medicaid-enrolled patients with psoriasis
    Bhosle, Monali
    Feldman, Steven
    Camacho, Fabian
    Balkrishnan, Rajesh
    JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2007, 56 (02) : AB107 - AB107
  • [33] Declining Medicaid Fees and Primary Care Appointment Availability for New Medicaid Patients
    Candon, Molly
    Zuckerman, Stephen
    Wissoker, Douglas
    Saloner, Brendan
    Kenney, Genevieve M.
    Rhodes, Karin
    Polsky, Daniel
    JAMA INTERNAL MEDICINE, 2018, 178 (01) : 145 - 146
  • [34] Predictors of Adequate Depression Treatment among Medicaid-Enrolled Adults
    Teh, Carrie Farmer
    Sorbero, Mark J.
    Mihalyo, Mark J.
    Kogan, Jane N.
    Schuster, James
    Reynolds, Charles F., III
    Stein, Bradley D.
    HEALTH SERVICES RESEARCH, 2010, 45 (01) : 302 - 315
  • [35] MEDICAID AND NON-MEDICAID DRUG DISCARDS IN LONG-TERM CARE FACILITIES
    SHEPHERD, MD
    CONTEMPORARY PHARMACY PRACTICE, 1979, 2 (01) : 14 - 20
  • [37] Comparing asthma care for medicaid and non-medicaid children in a health maintenance organization
    Finkelstein, JA
    Barton, MB
    Donahue, JG
    Algatt-Bergstrom, P
    Markson, LE
    Platt, R
    ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2000, 154 (06): : 563 - 568
  • [38] Prevalence, Patterns, and Cost of Care for Children with Cerebral Palsy Enrolled in Medicaid Managed Care
    Pulgar, Sonia
    Bains, Savreet
    Gooch, Judith
    Chambers, Henry
    Noritz, Garey H.
    Wright, Edward
    Sawhney, Tia Goss
    Pyenson, Bruce
    Ferro, Christine
    JOURNAL OF MANAGED CARE & SPECIALTY PHARMACY, 2019, 25 (07): : 817 - 822
  • [39] Impacts of family-informed care for people with disabilities enrolled in Medicaid managed care
    Owen, Randall
    Crabb, Caitlin
    Stober, Kaitlin
    Heller, Tamar
    JOURNAL OF FAMILY SOCIAL WORK, 2020, 23 (05) : 431 - 448
  • [40] Predictors of adequate depression treatment among Medicaid-enrolled youth
    Stein, Bradley D.
    Sorbero, Mark J.
    Dalton, Erin
    Ayers, Amanda M.
    Farmer, Carrie
    Kogan, Jane N.
    Goswami, Upasna
    SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 2013, 48 (05) : 757 - 765